To the Editor Our survey of primary care physicians on current treatment patterns for hoarseness and laryngopharyngeal reflux1 was the topic of a From The JAMA Network commentary by Dr Fisichella.2 Fisichella summarized these findings in the context of the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) clinical practice guidelines on hoarseness and concluded that empirical use of proton pump inhibitors (PPIs) is reasonable for patients with hoarseness and symptoms of gastroesophageal reflux disease (GERD).